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Purpose To describe a trypan blue dye staining technique under air, a modification of the previously described 30 G needle under-air technique. Design This is a prospective, randomized study of 1,000 eyes of 952 patients undergoing phacoemulsification in a private practice setting from January 2015 to August 2016. Three variants as a modification of the previously known 30 G needle technique are described. In our technique, after injecting one drop of the dye under air, the needle is kept in the anterior chamber (AC) for 15 seconds. In the second variation, along with the additional hold time, 0.05 mL air is injected prior to dye injection to deepen the AC in eyes with shallow ACs or in cases with increased posterior pressure. The third variation is the selective painting approach in which more than one drop is injected for a homogenous staining. Main outcome measures The main outcome measures were safety and reproducibility of the technique along with homogeneity and uniformity of the anterior capsule staining. Results AC remained stable during the hold time of 15 seconds with no egress of air. No iatrogenic trauma occurred in any of the cases. All cases had a homogeneously stained anterior capsule. The staining intensity was excellent in 80.8% of the eyes and good in 19.2% of the eyes. Conclusion This is a safe, simple, and cost-effective technique which achieves consistent, uniform, and reproducible staining. It overcomes the shortcomings of the known 30 G needle technique., Video abstract

Objective: to investigate the correlation between the tongue pressure and the electrical activity of the suprahyoid muscles. Methods: a across-sectional, observational and analytical study conducted with 15 men and 22 women. Each participant underwent simultaneous assessment of maximal tongue pressure through the Iowa Oral Performance Instrument (IOPI) and the surface electromyography of the suprahyoid muscles. They were asked to press the tongue against the hard palate in the anterior and posterior region, with and without IOPI. The adopted significance level of the performed analyses was 5%. Results: there was a moderate and significant correlation only between suprahyoid electrical activity and tongue pressure in the posterior region. It was verified that the measured electrical potentials, when using the IOPI, were greater in the tasks of anterior pressure than in the tasks of the posterior one, bilaterally. Without using the IOPI, the electrical potentials were greater in the posterior pressure than in the anterior one, bilaterally. Finally, the values of lingual pressure were compared with the bulb positioned in the anterior and posterior parts, and the anterior tongue pressure was higher. Conclusion: there was a moderate correlation between tongue pressure and electrical potential of the suprahyoid muscles, researched by the surface electromyography, only when performing activities with the posterior portion of the tongue.

[Purpose] In the present study, we aimed to determine the effects of backpack position on foot weight distribution of standing school-aged children. [Subjects] Thirty school-aged children volunteered to participate in this study. [Methods] The subjects randomly performed four types of carrying a backpack: no backpack (condition-1), carrying a backpack at C7 (condition-2), carrying a backpack at 10 cm below C7 (condition-3), and carrying a backpack at 20 cm below C7 (condition-4). [Results] Statistically significant differences were noted in the anterior and posterior pressure values, and in the anterior-to-posterior ratio, among the four conditions (p < 0.05). Post-hoc analysis indicated that the pressure value of condition-4 was significantly lower in the anterior foot region and higher in the posterior foot region than in condition-2 and condition-3. In addition, the anterior-to-posterior ratio was lower in condition-4 than in condition-2 and condition-3. [Conclusion] These findings suggest that carrying a backpack in a higher position, with fastening of the shoulder strap, may be more favorable for normalizing the foot weight distribution.

Backgroud To evaluate the symmetry of corneal biomechanical metrics, measured using an ocular response analyzer (ORA) and self-built corneal inflation test platform, in bilateral rabbit corneas and to investigate their relationship with physical intraocular pressure (IOPp). Methods Twenty fresh enucleated eyes from ten rabbits were used for ex vivo whole ocular globe inflation. IOP was increased from 7.5 to 37.5 mmHg with 7.5 mmHg steps and biomechanical metrics were acquired using the ORA. At least 3 examinations were performed at each pressure stage. Two biomechanical metrics, corneal hysteresis (CH) and corneal resistance factor (CRF) were recorded and analyzed as a function of IOPp. Corneal specimens were then excised from the intact ocular globe and tested under inflation conditions up to 45.7 mmHg posterior pressure. The experimental pressure-deformation data was analyzed using an inverse modeling procedure to derive the stress-strain behavior of the cornea. Results A comparison of corneal shape parameters showed no statistically significant difference (P > 0.05) between bilateral eyes. Similarly, there were no statistically significant differences in values of CH, CRF and corneal stiffness (as measured by the tangent modulus, Et) between bilateral eyes (CH: F = 0.94, P = 0.54; CRF: F = 4.42, P = 0.35; Et: F = 3.15, P = 0.12) at different pressure levels. IOPp was highly correlated with CRF while the relationship with CH was less pronounced. Conclusions An obvious interocular symmetry in biomechanical metrics is found in this research. IOP has been shown to have important influences on the value of CRF provided by ORA.

Purpose. To explore the probability and variation in biomechanical measurements of rabbit cornea by a modified Scheimpflug device.Methods. A modified Scheimpflug device was developed by imaging anterior segment of the model imitating the intact eye at various posterior pressures. The eight isolated rabbit corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at posterior pressures of 15, 30, 45, 60, and 75 mmHg by the device. The repeatability and reliability of the parameters including CCT, ACD, ACV, and CV were evaluated at each posterior pressure. All the variations of the parameters at the different posterior pressures were calculated.Results. All parameters showed good intraobserver reliability (Cronbach’s alpha; intraclass correlation coefficient,α, ICC > 0.96) and repeatability in the modified Scheimpflug device. With the increase of posterior pressures, the ratio of CCT decreased linearly and the bulk modulus gradually reduced to a platform. The increase of ACD was almost linear with the posterior pressures elevated.Conclusions. The modified Scheimpflug device was a valuable tool to investigate the biomechanics of the cornea. The posterior pressure 15–75 mmHg range produced small viscoelastic deformations and nearly linear pressure-deformation response in the rabbit cornea.

PURPOSE The aim of this study was to determine a noninvasive method of evaluating external iliac endofibrosis in cyclists. METHODS Eighteen highly trained male cyclists were divided into two groups: a pathology group (PG; 3 professional and 4 elite) and a control group (CG; 6 professional and 5 elite). Mean age was 26 +/- 6.1 yr for the PG and 24 +/- 4.09 for the CG. We studied humeral and tibial posterior pressure by using Doppler ultrasound and the ankle to arm index (AAI) before and after an incremental exercise test, performed on bike-ergometer until exhaustion. A Wilcoxon test was used to compare pressures and AAI in the PG. A Mann-Whitney test was used to compare the PG with the CG. Fisher discriminant analysis was done to obtain a classification of the legs in ill or normal legs. RESULTS The minimal AAI achieved in the PG was 0.76 +/- 0.13 for the normal leg (NL) and 0.35 +/- 0.04 for the ill leg (IL). We found significant differences (P < 0.01) from the 1st to 4th minute after exercise between the NL and the IL in the PG, and from the 1st to 10th minute after exercise between the IL and CG. We found significant differences in leg pressures between NL and IL in PG from the 1st to 4th minute (P < 0.01), and from the 1st to the 10th minute after exercise between CG and IL in the PG. Through discriminant analysis, we obtained a classification of the legs as ill or normal by applying a mathematical function at each recovery time studied. CONCLUSIONS AAI and leg pressures response to maximal exercise is a valid and noninvasive method for the evaluation of external iliac endofibrosis.

We experienced two cases of the influx of the sclerotomy site bleeding into the anterior chamber during 23-gauge sutureless vitrectomy for pseudophakic rhegmatogenous retinal detachment. Soon after the removal of a 23-gauge microcannula at the end of the surgery, presumed sclerotomy site hemorrhage was rapidly fluxed into the anterior chamber. The anterior chamber bleeding might come from the sclerotomies rather than from episcleral vessels. The posterior pressure in the gas-filled pseudophakic eye might have pushed the sclerotomy site bleeding into the anterior chamber. We could not find any vitreous hemorrhages. The hemorrhage within the anterior chamber spontaneously absorbed within 14 days.

An experimental study has been conducted to determine the stress–strain behaviour of human corneal tissue and how the behaviour varies with age. Fifty-seven well-preserved ex vivo donor corneas aged between 30 and 99 years were subjected to cycles of posterior pressure up to 60 mm Hg while monitoring their behaviour. The corneas were mechanically clamped along their ring of scleral tissue and kept in physiological conditions of temperature and hydration. The tissue demonstrated hyper-elastic pressure-deformation and stress–strain behaviour that closely matched an exponential trend. Clear stiffening (increased resistance to deformation) with age was observed in all loading cycles, and the rate of stiffness growth was nonlinear with bias towards older specimens. With a strong statistical association between stiffness and age ( p < 0.05), it was possible to develop generic stress–strain equations that were suitable for all ages between 30 and 99 years. These equations, which closely matched the experimental results, depicted corneal stiffening with age in a form suitable for implementation in numerical simulations of ocular biomechanical behaviour.

anot uncommoncomplication ofimperforate vagina in thenewborn. We donotpropose todiscuss the relatively commonproblem ofvaginal occlusion duetolabial adhesions (Fig. 1),whichcanbe easily separated withlittle ornobleeding. Hydrocolpos inthenewborn femaledueto imperforate hymenortoocclusion byamembrane inthelowerthird ofthevagina isnotexcessively rare.Atorshortly after birth theinfant presents withlower abdominal swelling andabulging membraneisseenatthevaginal orifice (Fig. 2).This bulging membrane looks like acystocele andwhen gently reduced theurethral orifice canbeseen anteriorly. Occasionally theremay be a tiny opening intheoccluding membrane through which a whitemucoidmaterial canbeextruded. The anomaly hasbeenfully described byMahoney andChamberlain (1940), byGross(1953), byCaffey (1956), andbymanyothers andforthepurposes ofthepresent communication a brief description oftheir findings will besufficient. Inthis condition thevagina isinvariably greatly distended-hydrocolpos-and onoccasions theaccumulated fluid canstretch thecervical canal andthe bodyoftheuterus aswell-hydrometrocolposthough wehaveseentheuterine cavity distended onlyononeoccasion. Theballooned genital tract arises fromthepelvic floor intotheabdominal cavity. Thecyst isfilled withclear ormucoid fluid whichtendstobecomepurulent frombacterial invasion, giving risetopyocolpos. Theuterine tubes havenotbeeninvolved inanyofthereported cases. The distended genital tractmay cause urinary obstruction andtheenlargement ofthe bladder mayhinder palpation ofthevaginal cyst. Megaloureter andhydronephrosis mayfollow and pyuria willbea further complication. Posterior pressure maycause rectal obstruction. Theremay * A paperreadatameeting oftheBritish Association ofPaediatric Surgeons heldinLondoninJuly1960. berespiratory embarrassment through theupward displacement of theabdominal contents. On digital rectal examination thepelvis isfilled bya massprojecting against thehollow ofthesacrum. On inspection ofthevagina abulging membrane isseenatorabovethehymen.Insuchpatients a needle isinserted through themembraneandfluid isaspirated toconfirm thediagnosis. Radioopaquefluidmay be instilled to outline the obstructed vagina(Fig.3).Havingmadethe diagnosis theoccluding membraneisslit witha knife andthecystcontents areevacuated. Lesscommonly thehydrocolpos isduetoatresia ofthelower vagina (White andDennison, 1958) and